Paediatric trauma

Question 1

Which gender are fractures more common in

Answer 1

boys

Question 2

What is the correlation with age and fractures

Answer 2

The older you are, the more likely you are to have had a fracture

Question 3

What is the correlation between previous fractures and obtaining new fractures

Answer 3

having a previous fracture, increases the risk of obtaining another fracture

Question 4

What season are paediatric fractures more common in

Answer 4

Summer

Question 5

What is the most common location for a paediatric fracture to be at

Answer 5

The forearm

Question 6

Why do children’s fractures heal quickly

Answer 6

They have a good blood supply and a metabolically active periosteum

Question 7

What are the types of fracture in children

Answer 7

Complete fracture

Greenstick fracture

Buckle fractures

Plastic deformity

Question 8

What is the Conservative treatment for childrens fractures

Answer 8

casts
braces
splints
traction

Question 9

What is the operative treatment of paediatric fracture

Answer 9

External fixation - pins are placed into the bone and there is an external frame

Internal fixation - Plate is applied to a broken bone and the fracture reduces

or Inter-medullary nails - placing elastic nails into the bone in children

Question 10

What causes remodelling of a childrens fracture

Answer 10

Appositional periosteal growth/resorption - children have a thick metabolically active periosteum which smoothens out any abnormalities on the bone by resorption

Question 11

Where is remodelling most active in bone

Answer 11

metaphysis

Question 12

What is the correlation between age and remodelling of a fracture

Answer 12

The younger a child is, the greater potential to remodel a fracture

Question 13

Why are all open fractures debrided

Answer 13

Because they are at risk to infection - removing all damaged or foreign material from the wound

Question 14

What cast is required for a straight limb

Answer 14

Bent cast

Question 15

What is the weakest point of the bone

Answer 15

The epiphyseal growth plate- weaker than ligaments

Question 16

What does the salter harris classification do

Answer 16

Helps predict injuries that may affect growth

Question 17

List the salter harris classification

Answer 17

SH1 – fracture is along the growth plate

SH2 – fracture begins along the growth plate but then angles off into the metaphysis – most common type

SH1 and 2 have good healing prospects

SH3 – fracture at a right angle to the growth plate – the growth plate tends to displace but the fracture doe s not go into the metaphysis

SH4 – Combination of SH2 and SH3 – goes in an oblique fashion across the growth plate

SH3 +4 – high risk of disturbance when healing

SH-5 – compression of the growth plate – longitudinal compression

Question 18

What is the most common salter harris fracture

Answer 18

Type 2 - Begins along the growth plate but then agles off into the metaphysis

Question 19

What are the stages of epiphyseal growth plate fusing

Answer 19

The centre fuses - then the medial side - then the lateral side

Question 20

What causes non accidental injury

Answer 20

Neglect
Child abuse

Question 21

What are the warnings of non accidental injury

Answer 21

inconsistent injury
Delay in presentation
Mechanism that doesn’t match the pattern of fracture
bruising
burns
multiple fractures with multiple stages of healing

Question 22

What is the treatment of osteomyelitis

Answer 22

Prolonged high does antibiotics -
2 weeks IV, 4 weeks oral

Question 23

What is the most common causing pathogen of osteomyelitis

Answer 23

Staphylococcus